Surgical Management of Synchronous, Bilateral Renal Masses: A 1-decade Referral Center Experience

Maida, Fabrizio Di; Grosso, Antonio Andrea; Sforza, Simone; Mari, Andrea; Lambertini, Luca; Nardoni, Samuele; Cocci, Andrea; Siena, Giampaolo; Masieri, Lorenzo; Tuccio, Agostino; Carini, Marco

doi:10.1016/j.euf.2022.01.010

Cited by 13 publications

(2 citation statements)

References 31 publications

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“…The institution where the study was conducted represents a tertiary referral center for minimally-invasive treatment of kidney cancer and is equipped with adequate technology as well as dedicated surgical, anesthesiologist and nursing team. Surgical procedure steps are discussed in previous publications [ 17 ]. Briefly, The Da Vinci Si system was used in all the cases, (Intuitive Surgical, Sunnyvale, CA, USA), in a three-arm configuration with a 30° laparoscope optic.…”

Section: Methodsmentioning

confidence: 99%

Three-dimensional virtual model for robot-assisted partial nephrectomy: a propensity-score matching analysis with a contemporary control group

Grosso,

Di Maida,

Lambertini

et al. 2024

World J Urol

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Purpose To compare two cohorts of patients submitted to robot-assisted partial nephrectomy (RAPN) with vs without the use of three-dimensional virtual models (3DVMs). Methods We screened a prospective consecutive cohort of 152 patients submitted to RAPN with 3DVM and 1264 patients submitted to RAPN without 3DVM between 2019 and 2022. Propensity score matching analysis (PSMA) was applied. Primary endpoint was to evaluate whereas RAPNs with 3DVM were superior in terms of functional outcomes at 12-month. Secondary endopoints were to compare perioperative and oncological outcomes. Multivariable logistic regression analyses (MVA) tested the associations of clinically significant eGFR drop and 3DVMs. Subgroups analysis was performed for PAUDA-risk categories. Results 100 patients for each group were analyzed after PSMA. RAPN with 3DVM presented a higher rate of selective/no clamping procedure (32% vs 16%, p = 0.03) and a higher enucleation rate (40% vs 29%, p = 0.04). As concern to primary endopoint, 12-month functional preservation performed better within 3DVM group in terms of creatinine serum level (median 1.2 [IQR 1.1–1.4] vs 1.6 [IQR 1.1–1.8], p = 0.03) and eGFR (median 64.6 [IQR 56.2–74.1] vs 52.3 [IQR 49.2–74.1], p = 0.03). However, this result was confirmed only in the PADUA ≥ 10 renal masses. Regarding secondary endpoints, no significative difference emerged between the two cohorts. MVA confirmed 3DVM as a protective factor for clinically significant eGFR drop only in high-risk (PADUA ≥ 10) masses. Conclusions RAPN performed with the use of 3DVM assistance resulted in lower incidence of global ischemia and higher rate of enucleations. The positive impact of such technology was found at 12-month only in high-risk renal masses.

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Section: Methodsmentioning

confidence: 99%

Three-dimensional virtual model for robot-assisted partial nephrectomy: a propensity-score matching analysis with a contemporary control group

Grosso,

Di Maida,

Lambertini

et al. 2024

World J Urol

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“…The surgical technique employed at our institution for robotic PN has already been described extensively [16] , [17] . In brief, once the tumor template has been marked with monopolar cautery, the natural, relatively avascular anatomic dissection plane is developed by blunt dissection using circumferential, dynamic tractions with the two robotic arms that lift the tumor off the parenchymal bed.…”

Section: Methodsmentioning

confidence: 99%

Redo Partial Nephrectomy for Local Recurrence After Previous Nephron-sparing Surgery. Surgical Insights and Oncologic Results from a High-volume Robotic Center

Di Maida,

Grosso,

Campi

et al. 2023

European Urology Open Science

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The current evidence on surgical management for synchronous bilateral renal tumors: results from a scoping review

et al. 2023

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Purpose Synchronous bilateral renal masses (SBRM) account for a low percentage of kidney tumors, and there is no current recommendation for their management. The objective was to review evidence regarding the best surgical approach for SBRM in terms of type and timing of surgery. Methods A broad literature search was performed on 28th January 2023 using Scopus, PubMed, and EMBASE. Only English papers dealing with adults were included. Meeting abstracts were excluded. Results Twenty-four papers were accepted and included. SBRM behave less aggressively than metachronous tumors, and partial nephrectomy (PN) is the preferred therapeutic option to preserve renal function. Open, laparoscopic, and robot-assisted approaches were found to be similar in oncological outcomes, though robot-assisted surgery resulted in lower comorbidities. Same-sitting PN was demonstrated to be a safe approach, particularly in the robotic-assisted one. Finally, the same-siting and staged NSS were similar in preserving renal function. Conclusions PN should be the desirable treatment for SBRM whenever feasible and if patients are fit, but surgeon expertise should also be taken into the account.

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Surgical Management of Synchronous, Bilateral Renal Masses: A 1-decade Referral Center Experience

Cited by 13 publications

References 31 publications

Three-dimensional virtual model for robot-assisted partial nephrectomy: a propensity-score matching analysis with a contemporary control group

Three-dimensional virtual model for robot-assisted partial nephrectomy: a propensity-score matching analysis with a contemporary control group

Redo Partial Nephrectomy for Local Recurrence After Previous Nephron-sparing Surgery. Surgical Insights and Oncologic Results from a High-volume Robotic Center

The current evidence on surgical management for synchronous bilateral renal tumors: results from a scoping review

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